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CHOP Surgeons Separate Conjoined Twins

November 8, 2012 — At approximately 3:40 p.m. today, surgeons at The Children’s Hospital of Philadelphia (CHOP) successfully completed the separation of eight-month-old conjoined twins Allison June and Amelia Lee Tucker. The infant girls, from Adams, NY, were joined at the lower chest and abdomen and shared their chest wall, diaphragm, pericardium and liver.

Led by Holly L. Hedrick, MD, pediatric general, thoracic and fetal surgeon, a multidisciplinary team of approximately 40 members, including physicians, nurses and other medical staff from general surgery, plastic and reconstructive surgery, cardiac surgery, anesthesiology, radiology, and neonatology, participated in the separation, which lasted about 7 hours.

“Like all separations of conjoined twins, this was a very complex surgery, but it went very well and as expected,” said Hedrick. “Allison and Amelia are currently recovering in the Newborn/Infant Intensive Care Unit (N/IICU) and will be monitored closely by CHOP’s expert clinical teams for the duration of their recovery,” she added.

The surgery and reconstruction climaxed months of complex planning and preparation by a large interdisciplinary team from nearly every area of the hospital. It is the 21st time that surgeons at The Children’s Hospital of Philadelphia have separated a pair of conjoined twins.

Prenatal Evaluation and Delivery

The twins’ parents, Shellie and Greg Tucker, first learned that Shellie was carrying conjoined twins about 20 weeks into their pregnancy. They were quickly referred to CHOP’s Center for Fetal Diagnosis and Treatment for expert evaluation, including prenatal imaging: fetal MRI, fetal echocardiogram and ultrasound.

“After extensive prenatal testing and evaluation, the Center’s team of maternal-fetal medicine specialists, surgeons and others determined that the Tucker girls had a thoraco-omphalopagus connection and were excellent candidates for separation,” explained Hedrick. In a thoraco-omphalagous connection, twins are joined at the lower chest and abdomen.

Allison and Amelia were born in a planned C-section delivery on March 1 in CHOP’s Garbose Family Special Delivery Unit, the world’s first birthing unit dedicated to mothers carrying fetuses with known birth defects.

After delivery, the girls spent their first seven weeks of life in the Harriet and Ronald Lassin Newborn/Infant Intensive Care Unit (N/IICU), and then moved to a surgical step-down unit.

Preparing for Surgery

One of the many procedures required to prepare the twins for separation was to insert skin expanders to increase the skin surface available to cover exposed tissue after surgery. Months before the separation surgery, David Low, MD, a plastic surgeon, inserted the expanders in each infant.

At 6:30 this morning, anesthesiologist Phillip Bailey, DO, led the surgical preparation for the tightly orchestrated, complex procedure. Bailey coordinated with a team of 6 anesthesiologists, monitored the twins’ vital signs and administered their anesthesia through the full completion of the day-long operation.

The eight-month-old girls have spent their entire lives inside The Children’s Hospital of Philadelphia. “This has been one of the most incredible journeys for our family, but we are excited about the next phase in Allison’s and Amelia’s lives,” said Shellie Tucker.

As the separated infants recover from their surgery, they will be closely followed in the coming months by nutritionists, developmental pediatricians, and other specialists to ensure that they receive the best clinical care to enable them to thrive and grow.

“We expect that, with this complex surgery behind them, Allison and Amelia will receive the care, therapy and support to allow them to live full, healthy and independent lives,” concluded Hedrick.

Note to Editors and Producers

At the family’s request, CHOP and family members did not provide any media interviews before the separation surgery. At an appropriate time, after the twins have recovered from surgery, CHOP and the Tucker family will issue additional updates and offer interview opportunities. CHOP and the family are grateful for the media’s understanding and respect for privacy.

Members of the news media who are interested in telling the Tucker family’s story can contact Ashley Moore, public relations specialist at The Children's Hospital of Philadelphia, by email at moorea1@email.chop.edu or by phone at 267-426-6071.

About Conjoined Twins

Doctors at The Children's Hospital of Philadelphia have separated 20 sets of conjoined twins and have managed the care of many others whose separation was not surgically possible. Conjoined twins occur once in every 50,000 to 60,000 births; most are stillborn. Approximately 75 percent of conjoined twins are female and joined at least partially in the chest and share organs with one another. If they have separate sets of organs, chances for surgery and survival are greater than if they share the same organs.